The Assosiated Risk Factors Of Cardiac Valve Calcification And Its Prognosis In End-stage Renal Disease Patients

Background: Cardiovascular complication was the leading cause of morbidity and mortality in patients with end-stage renal disease(ESRD),and cardiac valve calcification(CVC)was closely related to the occurrence of cardiovascular complication,which was an important risk factor,had prognostic value.But the incidence and risk factors of CVC in ESRD patients with maintenance hemodialysis(MHD)were not fully clear at present,its prognosis on ESRD was also not completely understood.so this present article explored the possible influence factors and associated complications of CVC in ESRD patients with MHD.Methods: From October 2014 to December 2015,we selected 433 adult patients for dialysis vintage at least 3 months in our hemodialysis center.And we used echocardiography to detect the CVC.93 patients had CVC,meanwhile,we collected 200 MHD patients as control with non-cardiac valve calcification(nCVC)in the same period.The demographic data,clinical parameters,and laboratory parameters between the two groups were analyzed.Results: Of all ESRD patients in our hemodialysis center within a year,the incidence of CVC was 30.3%.Aortic valve calcification was the most common,followed by mitral valve calcification.The patients with CVC were more frequently accompanied with simple aorta artery,both aortic and coronary artery,and simple coronary artery calcification,Which was about 1.44,1.87,and 1.75 times in that of nCVC,respectively,they were also more likely to suffer from arrhythmia,heart failure and coronary heart disease(CHD).Moreover,the all-cause mortality also increased significantly.Spearman’s correlation analysis showed that ESRD patients with CVC were assosiated with vascular calcification,heart failure,and all-cause mortality(P < 0.05).Dialysis vintage and the history of hypertension in CVC were longer than that of nCVC.Incidence of diabetes,systolic pressure,diastolic pressure,pulse pressure,serum calcium,and calcium phosphorus product were higher in CVC,while hemoglobin,serum albumin,and high density lipoprotein cholesterol(HDL)were lower.Binary logistic regression analysis showed that dialysis vintage(P = 0.006,OR = 2.25),serum calcium(P = 0.046,OR = 2.04),diabetes(P = 0.037,OR = 1.81),and pulse pressure(P < 0.001,OR = 3.22)were the risk factors of CVC.But serum albumin(P = 0.047,OR = 0.54)was a protective factor for CVC.Conclusions: High incidence of CVC happened in ESRD patients,andaortic valve calcification was almost common.CVC was a danger sign in ESRD patients who had severe atherosclerosis,or accompanied with the mortality and morbidity of cardiovascular events.Dialysis vintage,serum calcium,diabetes,and pulse pressure were the independent risk factors of CVC,while serum albumin was a protective factor.